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            Becas Fotocopias CEFCE
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      <li class="form-line form-line-column" id="id_55" style="display: none; ">
        <label class="form-label-top" id="label_55" for="input_55">
          Recursa<span class="form-required">*</span>
        </label>
        <div id="cid_55" class="form-input-wide">
          <select class="form-dropdown validate[required]" style="width:50px" id="input_55" name="q55_recursa55">
            <option>  </option>
            <option value="si"> Si </option>
            <option selected="selected" value="no"> No </option>
          </select>
        </div>
      </li>
      <li class="form-line form-line-column" id="id_34">
        <label class="form-label-top" id="label_34" for="input_34"> Materia </label>
        <div id="cid_34" class="form-input-wide">
          <input type="text" class="form-textbox" id="input_34" name="q34_materia34" autocomplete="off" size="20">
        </div>
      </li>
      <li class="form-line form-line-column" id="id_53" style="display: none; ">
        <label class="form-label-top" id="label_53" for="input_53">
          Recursa<span class="form-required">*</span>
        </label>
        <div id="cid_53" class="form-input-wide">
          <select class="form-dropdown validate[required]" style="width:50px" id="input_53" name="q53_recursa53">
            <option>  </option>
            <option value="si"> Si </option>
            <option selected="selected" value="no"> No </option>
          </select>
        </div>
      </li>
    </ul>
    <ul class="form-section-closed" style="height: 60px; clear: both; cursor: default; " id="section_11">
      <li id="cid_11" class="form-input-wide">
        <div class="form-collapse-table" id="collapse_11"><span class="form-collapse-mid" id="collapse-text_11">DATOS GRUPO FAMILIAR</span><span class="form-collapse-right form-collapse-right-hide">&nbsp;</span>
        </div>
      </li>
      <li class="form-line" id="id_46">
        <label class="form-label-left" id="label_46" for="input_46">
          Monto ingresos familiar<span class="form-required">*</span>
        </label>
        <div id="cid_46" class="form-input">
          <input type="text" class="form-textbox validate[required, Numeric]" id="input_46" name="q46_montoIngresos" size="20">
        </div>
      </li>
      <li class="form-line" id="id_45">
        <label class="form-label-left" id="label_45" for="input_45">
          Composición del grupo familiar<span class="form-required">*</span>
        </label>
        <div id="cid_45" class="form-input"><span class="form-sub-label-container"><input type="text" class="form-textbox validate[required, Numeric]" id="input_45" name="q45_composicionDel45" size="2">
            <label class="form-sub-label" for="input_45"> Cantidad integrantes </label></span>
        </div>
      </li>
      <li class="form-line form-line-column" id="id_47">
        <label class="form-label-top" id="label_47" for="input_47">
          Tenes hermanos<span class="form-required">*</span>
        </label>
        <div id="cid_47" class="form-input-wide">
          <div class="form-multiple-column"><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_47_0" name="q47_tenesHermanos" value="si">
              <label for="input_47_0"> Si </label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_47_1" name="q47_tenesHermanos" value="no">
              <label for="input_47_1"> No </label></span><span class="clearfix"></span>
          </div>
        </div>
      </li>
      <li class="form-line form-line-column" id="id_48" style="">
        <label class="form-label-top" id="label_48" for="input_48"> Cuantos dependen del ingreso familiar </label>
        <div id="cid_48" class="form-input-wide">
          <input type="text" class="form-textbox validate[Numeric]" id="input_48" name="q48_cuantosDependen48" size="10">
        </div>
      </li>
    </ul>
    <ul class="form-section-closed" style="height: 60px; clear: both; cursor: default; " id="section_23">
      <li id="cid_23" class="form-input-wide">
        <div class="form-collapse-table" id="collapse_23"><span class="form-collapse-mid" id="collapse-text_23">SITUACIÓN SOCIOECONÓMICA</span><span class="form-collapse-right form-collapse-right-hide">&nbsp;</span>
        </div>
      </li>
      <li class="form-line form-line-column" id="id_57">
        <label class="form-label-left" id="label_57" for="input_57">
          Fuente de Ingresos<span class="form-required">*</span>
        </label>
        <div id="cid_57" class="form-input">
          <div class="form-multiple-column"><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox validate[required]" id="input_57_0" name="q57_fuenteDe57[]" value="padres">
              <label for="input_57_0"> Padres/Tutores </label></span><span class="clearfix"></span><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox validate[required]" id="input_57_1" name="q57_fuenteDe57[]" value="becas">
              <label for="input_57_1"> Becas </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_57_2" name="q57_fuenteDe57[]" value="trabajo">
              <label for="input_57_2"> Trabajo </label></span><span class="clearfix"></span><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox validate[required]" id="input_57_3" name="q57_fuenteDe57[]" value="pensiondisc">
              <label for="input_57_3"> Pensión por discapacidad </label></span><span class="clearfix"></span>
          </div>
        </div>
      </li>
      <li class="form-line form-line-column" id="id_26">
        <label class="form-label-left" id="label_26" for="input_26">
          Con quién vive?<span class="form-required">*</span>
        </label>
        <div id="cid_26" class="form-input">
          <div class="form-multiple-column"><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_26_0" name="q26_conQuien" value="solo">
              <label for="input_26_0"> Vive solo </label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_26_1" name="q26_conQuien" value="padres">
              <label for="input_26_1"> Padres </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio validate[required]" id="input_26_2" name="q26_conQuien" value="compa">
              <label for="input_26_2"> Compañero </label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_26_3" name="q26_conQuien" value="pension">
              <label for="input_26_3"> Pensión </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio validate[required]" id="input_26_4" name="q26_conQuien" value="hermano">
              <label for="input_26_4"> Hermano </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left"><input type="radio" class="form-radio-other form-radio validate[required]" name="q26_conQuien" id="other_26">
              <input type="text" class="form-radio-other-input" name="q26_conQuien[other]" size="15" id="input_26" disabled="" placeholder="otro">
              <br></span>
          </div>
        </div>
      </li>
      <li class="form-line" id="id_60">
        <label class="form-label-left" id="label_60" for="input_60">
          Alquila?<span class="form-required">*</span>
        </label>
        <div id="cid_60" class="form-input">
          <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio validate[required]" id="input_60_0" name="q60_alquila60" value="Si">
              <label for="input_60_0"> Si </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio validate[required]" id="input_60_1" name="q60_alquila60" value="No">
              <label for="input_60_1"> No </label></span><span class="clearfix"></span>
          </div>
        </div>
      </li>
      <li class="form-line form-line-column" id="id_39" style="display: none; ">
        <label class="form-label-left" id="label_39" for="input_39"> Monto de alquiler </label>
        <div id="cid_39" class="form-input"><span class="form-sub-label-container"><input type="text" class="form-textbox validate[Numeric]" id="input_39" name="q39_montoDe" size="20">
            <label class="form-sub-label" for="input_39"> Cuanto pagas vos </label></span>
        </div>
      </li>
      <li class="form-line" id="id_43">
        <label class="form-label-left" id="label_43" for="input_43">
          Gastos fijos aproximados<span class="form-required">*</span>
        </label>
        <div id="cid_43" class="form-input"><span class="form-sub-label-container"><input type="text" class="form-textbox validate[required, Numeric]" id="input_43" name="q43_gastosFijos43" size="20">
            <label class="form-sub-label" for="input_43"> Cuanto pagas vos </label></span>
        </div>
      </li>
      <li class="form-line" id="id_59">
        <label class="form-label-left" id="label_59" for="input_59">
          Como asiste a cursar (transporte)<span class="form-required">*</span>
        </label>
        <div id="cid_59" class="form-input">
          <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio validate[required]" id="input_59_0" name="q59_comoAsiste59" value="colectivo">
              <label for="input_59_0"> Colectivo </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio validate[required]" id="input_59_1" name="q59_comoAsiste59" value="combinado">
              <label for="input_59_1"> Colectivo Combinado </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio validate[required]" id="input_59_2" name="q59_comoAsiste59" value="auto">
              <label for="input_59_2"> Auto/moto </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio validate[required]" id="input_59_3" name="q59_comoAsiste59" value="bici">
              <label for="input_59_3"> Bicicleta </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio validate[required]" id="input_59_4" name="q59_comoAsiste59" value="pie">
              <label for="input_59_4"> A pie </label></span><span class="clearfix"></span>
          </div>
        </div>
      </li>
    </ul>
    <ul class="form-section-closed" style="height: 60px; clear: both; cursor: default; " id="section_27">
      <li id="cid_27" class="form-input-wide">
        <div class="form-collapse-table" id="collapse_27"><span class="form-collapse-mid" id="collapse-text_27">ENVIAR</span><span class="form-collapse-right form-collapse-right-hide">&nbsp;</span>
        </div>
      </li>
      <li class="form-line" id="id_5">
        <label class="form-label-left" id="label_5" for="input_5"> Comentarios </label>
        <div id="cid_5" class="form-input">
          <textarea id="input_5" class="form-textarea" name="q5_comentarios" cols="40" rows="6"></textarea>
        </div>
      </li>
      <li class="form-line" id="id_29">
        <label class="form-label-left" id="label_29" for="input_29">
          Ingrese el código de seguridad<span class="form-required">*</span>
        </label>
        <div id="cid_29" class="form-input">
          <div class="form-captcha">
            <label for="input_29"> <img alt="Captcha - Reload if it&#39;s not displayed" id="input_29_captcha" class="form-captcha-image" style="background:url(http://jotformz.com/images/loader-big.gif) no-repeat center;" src="./index_files/server.php" width="150" height="41"> </label>
            <div style="white-space:nowrap;">
              <input type="text" id="input_29" class="form-textbox validate[required]" name="captcha" style="width:130px;">
              <img src="./index_files/reload.png" alt="Reload" align="absmiddle" style="cursor:pointer" onclick="JotForm.reloadCaptcha(&#39;input_29&#39;);">
              <input type="hidden" name="captcha_id" id="input_29_captcha_id" value="d05b0f2910cde2ca794d0b4965d4986d">
            </div>
          </div>
        </div>
      </li>
      <li class="form-line" id="id_2">
        <div id="cid_2" class="form-input-wide">
          <div style="margin-left:156px" class="form-buttons-wrapper">
            <button id="input_2" type="submit" class="form-submit-button">
              Enviar
            </button>
          </div>
        </div>
      </li>
      <li style="display:none">
        Should be Empty:
        <input type="text" name="website" value="">
      </li>
    </ul>
  </div>
  <input type="hidden" id="simple_spc" name="simple_spc" value="21015785153651-21015785153651">
  <script type="text/javascript">
  document.getElementById("si" + "mple" + "_spc").value = "21015785153651-21015785153651";
  </script>
  <input type="hidden" class="form-hidden" value="" id="input_51" name="q51_materiasA">
</form>
<div class="form-autocomplete-list" style="list-style: none outside; position: absolute; z-index: 10000; display: none; "></div><div class="form-autocomplete-list" style="list-style: none outside; position: absolute; z-index: 10000; display: none; "></div><div class="form-autocomplete-list" style="list-style: none outside; position: absolute; z-index: 10000; display: none; "></div><div class="form-autocomplete-list" style="list-style: none outside; position: absolute; z-index: 10000; display: none; "></div><div class="form-autocomplete-list" style="list-style: none outside; position: absolute; z-index: 10000; display: none; "></div><div class="form-autocomplete-list" style="list-style: none outside; position: absolute; z-index: 10000; display: none; "></div></body></html>